RECURRENT VOICES: Doug King - Pivot Legal Society

In the Midst of a Mental Health Crisis, We are Failing Rural and Aboriginal Youth

By Doug King, Pivot Legal Society

Pivot was formed more than a decade ago in the face of a health and human rights crisis in Vancouver’s Downtown Eastside. Since then, we’ve fought legislation, policies, and practices that undermine human rights and intensify poverty, with positive impacts for this neighbourhood and beyond.

More and more, however, we’re finding ourselves drawn into communities outside of Vancouver. There’s a desperate need in rural communities for the legal and advocacy support that has been successful at creating change in the Downtown Eastside.

We’re failing our rural communities

Last month I was in Kamloops representing the Yunesit’in Government in a Coroner’s inquest into the death of Jacob Setah. Jacob died in June 2014 at Royal Inland Hospital hundreds of kilometres from this home and his family. After running away from the psychiatric ward Jacob climbed to the ledge of the nearby parkade, where he was confronted by RCMP officers. One of the officers tried unsuccessfully to use a Taser against Jacob in order to arrest him, and Jacob immediately turned and jumped off the building to his death.

The circumstances leading to Jacob’s death raise many questions about the life-threatening social issues facing Aboriginal, rural, and marginalized communities. Why aren’t there adequate mental health care facilities to treat rural and Aboriginal youth? Why are police the first responders in a mental health crisis? And why are they responding with force, leading to such disastrous outcomes?

Youth like Jacob—who begin experiencing symptoms of depression or psychosis and are in need of immediate mental health care—often need to travel significant distances to receive care.

In Jacob’s case, six months before his death he visited Cariboo Memorial Hospital in Williams Lake seeking help after his family became concerned about his mental state. He was prescribed medication but returned to his home community without any follow-up care or medical assistance of any kind, an all-too-common scenario for First Nations youth.

It is not surprising that Jacob’s situation continued to worsen. After attending Cariboo Memorial Hospital for the second time, Jacob was moved—against his will and without the consent of his family—to the Royal Inland Hospital in Kamloops because it was the closest place with a designated psychiatric facility. After five days in the psychiatric unit without visitors, he made the escape that led to his death.

Inadequate mental health services for rural youth

The recommendations made by the jury at the conclusion of the inquest point to one simple and tragic fact: Jacob’s death was preventable.

Of the 15 recommendations made, 13 were directed at health care providers and health authorities, urgently calling for immediate improvements to the way we deliver mental health care in our communities and at designated psychiatric facilities.

If Jacob had been provided mental health care as a youth living on reserve, or if Williams Lake had adequate facilities to treat youth in mental health crisis, his death could likely have been prevented.

What makes Jacob’s death so difficult to come to terms with is that he should never have been in Kamloops in the first place.

Rural communities need support

Across British Columbia and across Canada, marginalized communities are struggling.

At the same time I was attending the coroner’s inquest, community leaders in Attawapiskat, Ontario called out for help in the midst of a mental health crisis, which had seen 11 First Nations youth attempt suicide in 24 hours.

The story there is sadly similar to Jacob’s: a lack of health services in a rural, Aboriginal community. This is a crisis many years in the making, brought on by failing infrastructure and the inability to identify and address critical shortages in care.

We must do better. The need for change is desperate and urgent.

Here in B.C. there is reason to be hopeful. The last two years have seen the creation of the First Nations Health Authority and the laying of a foundation for significant changes to the way health care is provided to First Nations communities.

Now we owe it to Jacob, and current and future generations of First Nations youth growing up on reserves, to act on the recommendations of the jury and make change a reality.